Medical Commerce, Physician Entrepreneurialism, and Conflicts of Interest

Abstract

Is medical commerce a recent phenomenon? Does it distort the patient-physician relationship? Are investor-owned firms the main source of medical commercialism? The author contends that medicine has generally been commerce in the United States, that commerce is a problem when it creates or worsens physicians' conflicts of interest, and that these conflicts thrive in non-profit organizations as well as in investor-owned firms. This article provides a historical sketch to show that physician entrepreneurialism, rather than commerce generally, is the main source of physicians' conflicts of interest.